The best news of the last month was something that most people entirely missed. Amidst all the distractions and noise that comprises modern media, a quiet press release discloses that a supercomputer has suddenly become more effective than human doctors in diagnosing certain types of ailments.

This is exceptionally important. As previously detailed in Chapter 3 of The ATOM, not only was a machine more competent than an entire group of physicians, but the machine continues to improve as more patients use it, which in turn makes it more attractive to use, which enables the accrual of even more data upon which to improve further.

But most importantly, a supercomputer like Watson can treat patients in hundreds of locations in the same day via a network connection, and without appointments that have to be made weeks in advance. Hence, such a machine replaces not one, but hundreds of doctors. Furthermore, it takes very little time to produce more Watsons, but it takes 30+ years to produce a doctor from birth, among the small fraction of humans with the intellectual ability to even become a physician. The economies of scale relative to the present doctor-patient model are simply astonishing, and there is no reason that 60-80% of diagnostic work done by physicians cannot soon be replaced by artificial intelligence. This does not mean that physicians will start facing mass unemployment, but rather than the best among them will be able to focus on more challenging problems. The most business-minded of physicians can incorporate AI into their practice to see a greater volume of patients on more complicated ailments.

This is yet another manifestation of various ATOM principles, from technologies endlessly crushing the cost of anything overpriced, to self-reinforcing improvement of deep learning.

"Jagdish Bhagwati, an economist at Columbia University, thinks that the offshoring of, for instance, customer service and claims-processing could save America alone $70 billion-75 billion a year."

"By Deloitte’s reckoning, medical travel will represent $162 billion in lost spending on health care in America by 2012. "

"A bit of rivalry from top foreign facilities may introduce transparency and price competition into an inefficient system riddled with oligopolies and perverse incentives. "

If some people thought the outsourcing of technical support and software development was significant, then medical tourism promises to be several times larger by the middle of the next decade. The Economist article provides a chart projecting the number of US patients expected to partake in medical tourism. The number is expected to grow from under 1 million today to over 15 million by 2017. By then, this could carve $250 Billion/year out of US healthcare spending, and pump $50 Billion/year into the destination countries, introducing $200 Billion/year of net deflationary benefit into the US economy. Everyone will know someone who went abroad for a medical procedure, with many customers comparing their experiences in India vs. Thailand vs. Jamaica.

1) Americans with no insurance are forced to make a life or death decision to get their surgeries abroad, where the service meets or exceeds their expections.

2) More insurance companies offer medical tourism with liability guarantees and cash/vacation incentives to American patients. Only a small fraction of patients are adventurous enough to do this, but all insurance companies are compelled to offer these options.

3) Major centers for medical tourism, after a track record of about a decade, develop solid brands that can attract American patients.

4) When we finally get to the point that 10% of Americans are traveling abroad for a wide array of procedures, the US will be forced to begin to take measures to reduce costs throughout the healthcare system. Losing 10% of the market is all that it will take to force some positive changes. This could begin to happen by 2020.

This confluence of market forces, globalization, and biotechnology is about to bring overdue reform to one of the biggest and worst sectors of the US and global economies. There are tremendous investment opportunities here, which I will write about in the near future.

The material consists of naturally occurring amino acids that have been engineered to form peptides that spontaneously cluster together to create long fibers when exposed to salty, aqueous environments, such as those found in the body. The fibers form a mesh that serves as a physical barrier to blood and other fluids.

Needless to say, this could save many lives on the battlefield, in car crashes, and during surgery. If it becomes inexpensive enough, it could even be part of home first-aid kits. Arch Theraputics is the company that is licensing the technology from MIT, and clinical trials are set to begin soon.

Most of these will be available to average consumers within the next 7-10 years, and will extend lifespans while dramatically lowering healthcare costs (mostly through enhanced capabilities of early detection and prevention, as well as shorter recovery times for patients).� This is consistent with my expectation that bionanotechnology is quietly moving along established trendlines despite escaping the notice of most people.� These technologies will also move us closer to Actuarial Escape Velocity, where the rate of lifespan increases exceed that of real time.�

Another angle that these technologies effect is the globalization of healthcare.� We have previously noted the success of 'medical tourism' in US and European patients seeking massive discounts on expensive procedures.� These technologies, given their potential to lower costs and recovery times, are even more suitable for medical offshoring than their predecessors, and thus could further enhance the competitive position of the countries that are quicker to adopt them.� If the US is at the forefront of using the 'bloodstream bot' to unclog arteries, the US thus once again becomes more attractive than getting a traditional procedure done in India or Thailand.� But if the lower cost destinations also adopt these technologies faster than the heavily regulated US, then even more revenue migrates overseas and the US healthcare sector would suffer further deserved blows, and be under even greater pressure to conform to market forces.� As technology once again acts as the great leveler, another spark of hope for reforming the dysfunctional US healthcare sector has emerged.�

These technologies are near enough to availability that you may even consider showing this article to your doctor, or writing a letter to your HMO.� Plant the seed into their minds...

Two of the leading thinkers in the field of life extension, Ray Kurzweil and Aubrey de Grey, believe that by the 2020s, human life expectancy will increase by more than one year every year (in 2002 Kurzweil predicted that this would happen as soon as 2013, but this is just another example of him consistently overestimating the rate of change). This means that death will approach the average person at a slower rate than the rate of technology-driven lifespan increases. It does not mean all death suddenly stops, but it does mean than those who are not close to death do have a possibility of indefinite lifespan after AEV is reached. David Gobel, founder of the Methuselah Foundation, has termed this as Actuarial Escape Velocity (AEV), essentially comparing the rate of lifespan extension to the speed at which a spacecraft can surpass the gravitiational pull of the planet it launches from, breaking free of the gravitational force. Thus, life expectancy is currently, as of 2007 data, rising at 20% of Actuarial Escape Velocity.

I remain unconvinced that such improvements will be reached as soon as Ray Kurzeil and Aubrey de Grey predict. I will be convinced after we clearly achieve 50% of AEV in developed countries, where six months are added to life expectancy every year. It is possible that the interval between 50% and 100% of AEV comprises less than a decade, but I'll re-evaluate my assumptions when 50% is achieved.

Serious research efforts are underway. The Methuselah Mouse Prize will award a large grant to researchers that can demonstrate substantial increases in the lifespan of a mouse (more from The Economist). Once credible gains can be demonstrated, funding for the research will increase by orders of magnitude.

The enormous market demand for lifespan extension technologies is not in dispute. There are currently 95,000 individuals in the world with a net worth greater than $30 million, including 1125 billionaires. Accelerating Economic Growth is already growing the ranks of the ultrawealthy at a scorching pace. If only some percentage of these individuals are willing to pay a large portion of their wealth in order to receive a decade or two more of healthy life, particularly since money can be earned back in the new lease on life, then such treatment already has a market opportunity in the hundreds of billions of dollars. The reduction in the economic costs of disease, funerals, etc. are an added bonus. Market demand, however, cannot always supercede the will of nature.

This is only the second article on life extension that I have written on The Futurist, out of 154 total articles written to date. While I certainly think aging will be slowed down to the extent that many of us will surpass the century mark, it will take much more for me to join the ranks of those who believe aging can be truly reversed. To track progress in this field, keep one eye on the rate of decline in cancer and heart disease deaths, and another eye on the Methuselah Mouse Prize. That such metrics are even advancing on a yearly basis is already remarkable, but monitoring anything more than these two measures, at this time, would be premature.

So let's find out what the group prediction is, with a poll. Keep in mind that most people are biased towards believing this date will fall within their own lifetimes (poll closed 7/1/2012) :

Many procedures that cost $100,000 or more in the US can be done with equal competence for $10,000 in Thailand or India. Normally, if something of comparable quality is available for just a tenth of the cost, demand migrates to the cheaper alternative in a huge torrent. Even after accounting for travel costs, the gulf is immense. Yet it appears that only a small percentage of US patients for cardiovascular surgery, joint replacements, etc. are going overseas for their operations. Medical tourism will still only earn a miniscule $4 Billion in 2008 for India, Thailand, and Singapore combined, of which only one-third is from American patients. Thus, only a fraction of a percent of the US, European, and Japanese healthcare sectors have been dented.

This, of course, can be due to two reasons :

a) Fears about quality/safety, either real or perceived.

b) Net out-of-pocket cost to the patient still being lower in the US, due to insurance.

Regarding quality, many of these surgeons are certified by US boards or even educated in US colleges, and accidents do not appear to happen at any greater rate than in the US. At the same time, it is not possible to pursue malpractice suits against facilities in India or Thailand, which, while certainly an element of risk, itself is part of the reason for their lower price relative to the US. It is inevitable that some mishap befalls an American patient in Asia, and the media latches onto the story for a week or more, reversing the market demand for medical tourism for years, even if the incidence of such tragedies may be no more than in US hospitals. In fact, I am surprised it has not happened already.

In terms of cost, that brings us to the elephant in the room, which is the revelation that it is not India or Thailand that are too cheap, but rather that US healthcare is too expensive to begin with. I am no expert in this field, but it seems obvious that a lack of market forces in the value chain, a lack of regulation of lawsuits, the horrendous dietary habits of most Americans, and the tendency of consumers to not care about how much the insurance company pays are all contributory factors to what is arguably the greatest tragedy in US economic history. Socializing the healthcare system will worsen it, for reasons too vast to delve into here. It is true that many Canadians come to the US for urgent procedures that would require a 3-month wait in Canada.

However, millions of Americans don't have health insurance at all, and while for some this is by choice, for some it is not. For them, traveling abroad for a $10,000 heart procedure may be the only affordable option. Even if the most experienced and well-frequented facilities are in India and Thailand, nearby options also exist in Jamaica and Costa Rica. Over 20 other countries across Eastern Europe, Asia, and Latin America are also vying for a slice of the pie.

As unintended consequences ripple through, herein lies the path to forcing some degree of reform of the US healthcare system. As more Americans either choose or are forced to seek low-cost procedures abroad, even if it is only a small percentage American patients, this will compel insurance companies to include medical tourism options to patients. The insurance company can offer their own version of malpractice insurance to the patient, cover all travel expenses for the patient and spouse, and even throw in a vacation package and cash incentive. Even after all this, if the cost of the $10,000 procedure in India or Thailand has now risen to $30,000, it still outcompetes the $100,000 US alternative handily. Some insurance companies are already starting this with enthusiasm, and before long, all insurance companies will effectively have to compete on this level.

As the number of Americans combining surgeries with a tropical vacation becomes a small but significant percentage of the total patient pool, the US healthcare system will have no choice but to undertake the difficult reforms to bring costs down at a systemic level, thus benefiting even those Americans who refuse to go overseas, and even procedures that are not candidates for offshoring. If software development can be outsourced to India where it is one fourth the cost, surgeries cannot expect to be perpetually immune to competition that is a tenth or twentieth of the cost. Through some combination of tort reform, free-market principles, and preventative focus, US costs will gradually be brought down closer to a market rate. Perhaps the US can comfortably sustain prices that are 3 times that of Thailand, but not 10 times. This will be the next industry in the US that is forced to adapt.

To review, the expected sequence of events is :

1) Americans with no insurance are forced to make a life or death decision to get their surguries abroad, where the service meets or exceeds their expectations.

2) More insurance companies offer medical tourism with liability guarantees and cash/vacation incentives to American patients. Only a small fraction of patients are adventurous enough to do this, but all insurance companies are compelled to offer these options.

3) Major centers for medical tourism, after a track record of about a decade, develop solid brands that can attract American patients.

4) When we finally get to the point that 10% of Americans are traveling abroad for a wide array of procedures, the US will be forced to begin to take measures to reduce costs throughout the healthcare system. Losing 10% of the market is all that it will take to force some positive changes. This could begin to happen by 2020.

Such a sequence of events, of course, will boost the US economy greatly. Of the $2 Trillion mentioned above, as much as half of that, a whopping $1 Trillion or 7% of the US economy, is estimated to be wastage incurred due to a shortage of market forces in healthcare. Imagine if that $1 Trillion could be redeployed elsewhere. A person who saves $90,000 on a heart procedure can choose to use that money on emerging innovations in biotechnology that may be available in the 2020s, such as treatments to slow down or halt some aspects of aging.

This is not going to be a trend that moves as quickly as some of the others discussed here on The Futurist. But the economics involved are massive enough that it has certainly caught my eye. Let's see what happens, both before and after the predicted media frenzy over a foreign medical mishap.

The article also mentions how hospitals are opposed to these technological advancements, as they reduce the number of days of revenue a hospital can collect while a patient recovers after surgury. This anti-productive, entitlement mentality will hasten the downfall of the US healthcare cartel, as shorter recovery times due to smaller incisions will make a trip to a tech-friendly facility in Thailand or India even more compelling. When the cost is a tenth and the recovery time is a fifth of what it would be in the US, how long before market forces dominate?

In scouring the startup universe for the companies and technologies that can reshape human society and create entirely new industries, one has to play the role of a prospective Venture Capitalist, yet not be constrained by the need for a financial exit 3-6 years hence.

Therefore, I have assembled a list of nine small companies, each with technologies that have the potential to create trillion-dollar economic disruptions by 2020, disruptions that most people have scarcely begun to imagine today. Note that the emphasis is on the technologies rather than the companies themselves, as a startup requires much more than a revolutionary technology in order to prosper. Management skills, team synergy, and execution efficiency are all equally important. I predict that out of this list of nine companies, perhaps one or two will become titans, while the others will be acquired by larger companies for modest sums, enabling the technology to reach the market through the acquiring company.

1) NanoSolar : NanoSolar produces low-cost solar cells that are manufactured by a process analogous to 'printing'. The company's technology was selected by Popular Mechanics as the 'Innovation of the Year' for 2007, and Nanosolar's solar cells are significantly ahead of the Solar Energy Cost Curve. The flexible, thin nature of Nanosolar's cells may enable them to be quickly incorporated onto the surfaces of many types of commercial buildings. Nanosolar's first shipments have already occurred, and if we see several large deployments in the near future, this might just be the company that finally makes solar energy a mass-adopted consumer technology. Nanosolar itself calls this the 'third wave' of solar power technology.

2) Tesla Motors : I wrote about Tesla Motors in late 2006. Tesla produces fully electric cars that can consume as little as 1 cent of electricity per mile. They are about to deliver the first few hundred units of the $98,000 Tesla Roadster to customers, and while the Roadster is not a car that can be marketed to average consumers, Tesla intends to release a 4-door $50,000 sedan named 'WhiteStar' in 2010, and a $30,000 sedan by 2013. The press coverage devoted to Tesla Motors has been impressive, but until the WhiteStar sedan successfully sells at least 10,000 units, Tesla will not have silenced critics who say the technology cannot be brought down to mass-market costs.

3) Aptera Motors : When I first wrote about Tesla Motors, it was before I had heard about Aptera Motors. While Tesla is aiming to produce a $30,000 sedan for 2013, Aptera already has an all-electric car due for late 2008 that is priced at just $27,000, while delivering the equivalent of between 200 and 330 mpg. The fact that the vehicle has just three wheels may reduce mainstream appeal to some degree, but the futuristic appearance of the car will attract others. Aptera Motors is a top candidate for winning the Automotive X-Prize in 2010.

The simultaneous use of Nanosolar's solar panels with the all-electric cars from Tesla and Aptera may enable automotive driving to be powered by solar generated electricity for the average single-family household. The combination of these two technologies would be the 'killer ap' of getting off of oil and onto fully renewable energy for cars.

4) 23andMe : This company gets some press due to the fact that co-founder Anne Wojcicki is married to Sergey Brin, even as Google has poured $3.9M into 23andMe. Aside from this, what 23andMe offers is an individual's personal genome for just $1000. What a personal genome provides is a profile of which health conditions the customer is more or less susceptible to, and thus enables the customer to provide this information to his physician, and make the preventive lifestyle adjustments well in advance. Proactive consumers will be able to extend their lifespans by systematically reducing their risks of ailments they are genetically predisposed to. As the service is a function of computational power, the price of a personal genome will, of course, drop, and might become an integral part of the average person's medical records, as well as an expense that insurance covers.

5) Desktop Factory : In 2008, Desktop Factory will begin to sell a $5000 device that functions as a 3-D printer, printing solid objects one layer at a time. A user can scan almost any object (including a hand, foot, or head) and reproduce a miniature model of it (up to 5 X 5 X 5 inches). The material used by the 3-D printer costs about $1 per cubic inch.

The $5000 printer is a successor to similar $100,000 devices used in mechanical engineering and manufacturing firms. Due to the Impact of Computing, consumer-targeted devices costing under $1000 will be available no later than 2014. I envision an ecosystem where people invent their own objects (statuettes, toys, tools, etc.) and share the scanned templates of these objects on social networking sites like MySpace and Facebook. People can thus 'share' actual objects over the Internet, through printing a downloaded template. The cost of the printing material will drop over time as well. A lot of fun is to be had, and expect an impressive array of brilliant ideas to come from people below the age of 16.

6) Zazzle : Welcome to the age of the instapreneur. Zazzle enables anyone to design their own consumer commodities like T-shirts, mugs, calendars, bumper stickers, etc. on demand. If you have an idea, you can produce it on Zazzle with no start-up costs, and no inventory risks. You profit even from the very first unit you sell, with no worries about breakeven thresholds. You can produce an infinite number of products, limited only by your imagination. At this point, those of you reading this are probably in the midst of an avalanche of ideas of products you would like to produce.

While the bulk of Zazzle users today are would merely be vanity users who manage to sell under ten units of their creations, this new paradigm of low-cost customization will inevitably creep up to major industrial supply chains. Even more interesting, think about #5 on this list, Desktop Factory, combining with Zazzle's application, into an amazing transformation of the very economics of manufacturing and mass-production.

9) Ugobe : Ugobe sells a robotic dinosaur toy known as the Pleo. A mere toy, especially a $350 toy, would not normally be on a list of technologies that promise to crease the fabric of human society. However, a closer look at the Pleo reveals many impressive increments in the march to make inexpensive robots more lifelike. The skin of the Pleo covers the joints, the Pleo has more advanced 'learning' abilities than $2500 robots from a few years ago, and the Pleo even cries when tortured, to the extent that it is difficult to watch this.

The reason Ugobe is on this list is that I am curious to see what is the next product on their roadmap, so that I can gauge how quickly the technology is advancing. The next logical step would be an artificial mammal of some sort, with greater intelligence and realistic fur. The successful creation of this generation of robot would provide the datapoints to enable us to project the approximate arrival of future humanoid robots, for better or for worse. Another company may leapfrog Ugobe in the meantime, but they are currently at the forefront of the race to create low-priced robotic toys.

This concludes the list of nine companies that each could greatly alter our lives within the next several years. Of these nine, at least three, Nanosolar, Tesla Motors, and 23andMe, have Google or Google's founders as investors. The next 24 months have important milestones for each of these companies to cross (by which time I might have a new list of new companies). For those that clear their respective near-term bars, there might just be a chance of attaining the dizzy heights that Google, Microsoft, or Intel has.

The Year in Nanotechnology : Stanford University research into nanowires that dramatically increase battery capacity is the most promising breakthrough of 2007, in any discipline. Think 30-hour laptop batteries.

Most of the innovations in the articles above are in the laboratory phase, which means that about half will never progress enough to make it to market, and those that do will take 5 to 15 years to directly affect the lives of average people (remember that the laboratory-to-market transition period itself continues to shorten in most fields). But each one of these breakthroughs has world-changing potential, and that there are so many fields advancing simultaneously guarantees a massive new wave of improvement to human lives.

This scorching pace of innovation is entirely predictable, however. To internalize the true rate of technological progress, one merely needs to appreciate :

We are fortunate to live in an age when a single calendar year will invariably yield multiple technological breakthroughs, the details of which are easily accessible to laypeople. In the 18th century, entire decades would pass without any observable technological improvements, and people knew that their children would experience a lifestyle identical to their own. Today, we know with certainty that our lives in 2008 will have slight but distinct and numerous improvements in technological usage over 2007, just as 2007 was an improvement over 2006.

The Lifeboat Foundation has a special report detailing their view of the top ten transhumanist technologies that have some probability of 25 to 30-year availability. Transhumanism is a movement devoted to using technologies to transcend biology and enhance human capabilities.

I am going to list out each of the ten technologies described in the report, provide my own assessment of high, medium, or low probability or mass-market availability by a given time horizon, and link to prior articles written on The Futurist about the subject.

10. Cryonics : 2025 - Low, 2050 - Moderate

I can see the value in someone who is severely maimed or crippled opting to freeze themselves until better technologies become available for full restoration. But outside of that, the problem with cryonics is that very few young people will opt to risk missing their present lives to go into freezing, and elderly people can only benefit after revival when or if age-reversal technologies become available. Since going into cryonic freezing requires someone else to decide when to revive you, and any cryonic 'will' may not anticipate numerous future variables that could complicate execution of your instructions, this is a bit too risky, even if it were possible.

The good news here is that gene sequencing techniques continue to become faster due to the computers used in the process themselves benefiting from Moore's Law. In the late 1980s, it was thought that the human genome would take decades to sequence. It ended up taking only years by the late 1990s, and today, would take only months. Soon, it will be cost-effective for every middle-class person to get their own personal genome sequenced, and get customized medicines made just for them.

While this is a staple premise of most science fiction, I do not think that space colonization may ever take the form that is popularly imagined. Technology #2 on this list, mind uploading, and technology #5, self-replicating robots, will probably appear sooner than any capability to build cities on Mars. Thus, a large spaceship and human crew becomes far less efficient than entire human minds loaded into tiny or even microscopic robots that can self-replicate. A human body may never visit another star system, but copies of human minds could very well do so.

Artificial limbs, ears, and organs are already available, and continue to improve. Artificial and enhanced muscle, skin, and eyes are not far.

5. Autonomous Self-Replicating Robots : 2030 - Moderate

This is a technology that is frightening, due to the ease at which humans could be quickly driven to extinction through a malfunction that replicates rouge robots. Assuming a disaster does not occur, this is the most practical means of space exploration and colonization, particular if the robots contain uploads of human minds, as per #2.

From the Great Wall of China in ancient times to Dubai's Palm Islands today, man-made structures are already visible from space. But to achieve transhumanism, the same must be done in space. Eventually, elevators extending hundreds of miles into space, space stations much larger than the current ISS (240 feet), and vast orbital solar reflectors will be built. But, as stated in item #7, I don't think true megascale projects (over 1000 km in width) will happen before other transhumanist technologies render the need for them obsolete.

2. Mind Uploading : 2050 - Moderate

This is what I believe to be the most important technology on this list. Today, when a person's hardware dies, their software in the form of their thoughts, memories, and humor, necessarily must also die. This is impractical in a world where software files in the form of video, music, spreadsheets, documents, etc. can be copied to an indefinite number of hardware objects.

If human thoughts can reside on a substrate other than human brain matter, then the 'files' can be backed up. That is all there is to it.

1. Artificial General Intelligence : 2050 - Moderate

This is too vast of a subject to discuss here. Some evidence of progress appears in unexpected places, such as when, in 1997, IBM's Deep Blue defeated Gary Kasparov in a chess game. Ray Kurzweil believes that an artificial intelligence will pass the Turing Test (a bellwether test of AI) by 2029. We will have to wait and see, but expect the unexpected, when you least expect it.

When most people think of termites, the reaction is predictably negative. After all, not only do they damage homes and bore holes through books, but they have a certain ugliness that even ants do not possess. However, this is another one of those times where a particularly formidable and vexing problem of civilizational significance meets a countering force from just about the last source anyone would expect. The loathed termite might actually attone for all the cumulative economic damage it has caused to human society over the centuries.

Both MIT Technology Review and BusinessWeek have, in the last 30 days, featured articles detailing how a termite's ability to digest wood is due to certain microbes in the digestive tract, which contain a gene that can be extracted and harnessed into processes to create cellulostic ethanol out of agricultural waste for a fraction of the current cost.

America's forests, agricultural waste, and 40 to 60 million acres of prairie grass could supply 100 billion gallons or more of fuel per year—while slashing greenhouse gas emissions. That would replace more than half the 150 billion gallons of gasoline now used annually, greatly reducing oil imports. It "will happen much faster than most people think," predicts Michigan State biochemical engineer Bruce E. Dale. "And it will be enormous, remaking our national energy policy and transforming agriculture."

Recent work has lowered the cost of this step thirtyfold, to about 50 cents per gallon of ethanol produced. "We now are not far away from the goal of 10 cents per gallon," says Glenn E. Nedwin, chief scientific officer at Dyadic.

Always remember that 1.5 units of ethanol are required to produce the same energy as 1 unit of gasoline. So far, US ethanol production has amounted to merely 7 billion gallons (enough to replace just 3% of gasoline consumption) in 2006, is barely cost-competitive with gasoline even with the agricultural subsidies the federal government has provided, and is heavily dependent on using corn which is also needed in the food industry. But if the termite enzyme can create a process that scales up to the extent of producing 100 billion gallons a year for under $1 per gallon (already a more modest goal than what the scientists in the article are striving for) out of otherwise unused biomass, we just might tackle oil dependence, greenhouse gas emissions, and the trade deficit simultaneously.

The progress they make between now and 2010 will enable us to determine if this is on track to becoming a technological reality by 2015.

Most of the innovations in the articles above are in the laboratory phase, which means that about half will never progress enough to make it to market, and those that do will take 5 to 15 years to directly affect the lives of average people (remember that the laboratory-to-market transition period itself continues to shorten in most fields). But each one of these breakthroughs has world-changing potential, and that there are so many fields advancing simultaneously guarantees a massive new wave of improvement to human lives.

This scorching pace of innovation is entirely predictable, however. To internalize the true rate of technological progress, one merely needs to appreciate :

We are fortunate to live in an age when a single calendar year will invariably yield multiple technological breakthroughs, the details of which are easily accessible to laypeople. In the 18th century, entire decades would pass without any observable technological improvements, and people knew that their children would experience a lifestyle identical to their own. Today, we know with certainty that our lives in 2007 will have slight but distinct and numerous improvements in technological usage over 2006.

There was a time when America could wage wars and sustain 50,000 or more casualties without severe domestic opposition. Not any more, as even 2000 hostile deaths in Iraq has caused many Americans to be demoralized from the seemingly immense body count. Our technological and economic progress has caused our society to rightly place a premium on human life, but in order to preserve our society, we still need to wage brutal wars. Thus, market forces demand innovations that reduce US troop deaths even further.

Active use by the military could be 8-10 years away. After that, it could be used by ambulances at traffic scenes or even during surgery.

But what is important is not whether this innovation, or the previously described ultrasound tourniquet, or some third technology wins out. What is important is that multiple unrelated technologies are rapidly closing in on a market need, forcing each of them to continually improve their efficacy and reduce their costs. This virtually ensures that the market need will be met in the near future.

There was a time when America could wage wars and sustain 50,000 or more casualties without severe domestic opposition. Not any more, as even 2000 hostile deaths in Iraq has caused many Americans to be demoralized from the seemingly immense body count. Our technological and economic progress has caused our society to rightly place a premium on human life, but in order to preserve our society, we still need to wage brutal wars. Thus, market forces demand innovations that reduce US troop deaths even further.

Accordingly, the Pentagon has provided $51 million for research towards the development of an ultrasound tourniquet that can stop the loss of blood from major wounds in as little as 30 seconds, and thus reduce troop deaths from guerilla/terrorist tactics (like those in Iraq) by over 50% by 2011 (Article : MIT Technology Review).

When the tourniquet is wrapped around a wounded limb or torso, it emits ultrasound beams that detect ruptured blood vessels and induce rapid clotting to seal them. This buys the wounded soldier enough time to be carried to an equipped medical facility, where previously he would often have died of blood loss before reaching the facility. Once at the emergeny room, his chances of survival continue to be higher than before from targetted sealing of severed arteries and veins. Thus, the damage from all but the most severe wounds can be greatly reduced.

The implications of this are immense. In Iraq, the majority of US troop deaths are from improvised explosive devices (IEDs), where shrapnel often inflicts fatal wounds. Additionally, for each troop killed, eight are wounded. This device could reduce such deaths by half or more, and even help the wounded return to action in a much shorter time. At the same time, none of our opponents would have such a technology, further widening the power gap between an elite US force and a terrorist cell. Eventually, this could become a medical device available in hospitals for civilian use, reducing the deaths from automobile accidents and gunshot wounds significantly, provided an ambulance arrives in time.

Such a tourniquet will not be available to the US military in an easily usable form for another 5 years, but when it is, US military effectiveness in the War on Terror will be increased dramatically, as will the willingness of the US public to engage in continued military activity. When our troops become harder to kill from mere IEDs and gunshot wounds, non-uniformed terrorists and insurgents will be blunted even further.

What would be the best way to measure, and predict, technological progress? One good observation has been The Impact of Computing, but why has computing occurred now, rather than a few decades earlier or later? Why is nanotechnology being talked about now, rather than much earlier or later?

Engineering has two dimensions of progress - the ability to engineer and manufacture designs at exponentially smaller scales, and the ability to engineer projects of exponentially larger complexity. In other words, progress occurs as we design in increasingly intricate detail, while simultaneously scaling this intricacy to larger sizes, and can mass produce these designs.

For thousands of years, the grandest projects involved huge bricks of stone (the Pyramids, medieval castles). The most intricate carvings by hand were on the scale of millimeters, but scaled only to the size of hand-carried artifacts. Eventually, devices such as wristwatches were invented, that had moving parts on a millimeter scale.

At the same time, engineering on a molecular level first started with the creation of simple compounds like Hydrochloric Acid, and over time graduated to complex chemicals, organic molecules, and advanced compounds used in industry and pharmaceuticals. We are currently able to engineer molecules that have tens of thousands of atoms within them, and this capability continues to get more advanced.

The chart below is a rough plot of the exponentially shrinking detail of designs which we can mass-produce (the pink line), and the increasingly larger atom-by-atom constructs that we can create (the green line). Integrated circuits became possible as the pink line got low enough in the 1970s and 80s, and life-saving new pharmaceuticals have emerged as the green line got to where it was in the 1990s and today. The two converge right about now, which is not some magical inflection point, but rather the true context in which to view the birth of nanotechnology.

As we move through the next decade, molecular engineering will be capable of producing compounds tens of times more complex than today, creating amazing new drugs, materials, and biotechnologies. Increasingly finer design and manufacturing capabilities will allow computer chips to accomodate 10 billion transistors in less than one square inch, and for billions of these to be produced. Nanotechnology will be the domain of all this and more, and while the beginnings may appear too small to notice to the untrained observer, the dual engineering trends of the past century and earlier converge to the conception of this era now.

Further into the future, molecule-sized intelligent robots will be able to gather and assemble into solid objects almost instantly, and move inside our body to monitor our health and fight pathogens without our noticing. Such nanobots will change our perception of physical form as we know it. Even later, picotechnology, or engineering on the scale of trillionths of a meter - that of subatomic particles - will be the frontier of mainstream consumer technology, in ways we cannot begin to imagine today. This may coincide with a Technological Singularity around the middle of the 21st century.

For now, though, we can sit back and watch the faint trickle of nanotechnology headlines, products, and wealth thicken and grow into a stream, then a river, and finally a massive ocean that deeply submerges our world in its influence.

For the last few years, despite robust GDP, productivity growth, and job creation, the average income of US workers has been rising at a very slow rate. Some of this was attributed to 'outsourcing', but this is not the case, as job creation would also have been weak, rather than just wage growth.

The reason for low wage growth has been healthcare costs greatly outpacing inflation during 2000-05. This consumes money that employers would have otherwise distributed towards employee salaries. Some of the rise in healthcare costs is due to an aging population, and some of this is due to the growing number of illegal immigrants not paying into a system they are using.

The chart below from the Bureau of Labor Statistics shows how the increased costs of benefits (mostly health insurance) has left little remaining money for salaries to rise. This is in sharp constrast to the late 1990s, when salaries could rise more rapidly due to subdued increases in healthcare costs.

In fact, the perception that the economy is weaker now relative to the late 1990s, despite nearly every economic indicator being comparable between the two periods, could be entirely due to this. People are getting weaker raises even when employers have increased spending on employees each year.

But we may be over the hump, as the data is finally trending in a favorable direction. Michael Mandel's blog has observed a decline in some of the technology-related components of healthcare costs. The costs of medical labs and imaging centers stopped rising altogether in the last year. Mandel says this may be due to competition, but I think this is due to technology. Not only are many advanced instruments subject to The Impact of Computing, and thus improving in power and number every year, but new drugs and gene therapies provide treatment that sometimes avoids hospital stays altogether. Exponentially improving technologies are pervasively moving into medicine to deliver faster, cheaper, more effective treatments, and this saves money even for people who are not users of them.

If the moderation in the price of high-tech medical costs continues, US wages may rise as employers can pass more on towards salaries instead of health insurance premiums.

Refer back to Part I here, where we discuss that despite the many stunning advances in medicine, there is still something within us that doubts that our present lives could be extended to 100 years.

The exponentially progressing advances in genomic and proteomic science will cure many genetic predispositions that an individual may have to certain diseases, again, with medical knowledge currently doubling every 8 years. Programmable nanobots that can keep us healthy from inside, by detecting cancerous cells or biochemical changes very early, are also a near-certainty by the 2020s. Furthermore, if just half of the world's 8 million millionaires were each willing to pay $500,000 to add 20 healthy, active years to their lives, the market opportunity would be (4 million X $500,000) = $2 trillion. The technological trend and market incentive is definitely in place for revolutions in this field.

But that is still not quite enough to assure that the internal mechanisms that make cells expire by a certain time, or the continuous damage done by cosmic rays perpetually going through our bodies, can be fully negated.

Ray Kurzweil, in his essay "The Law of Accelerating Returns", seems confident that additions to human lifespan will grow exponentially. While I agree with most of his conclusions in other areas, over here, I am not convinced that this growth is accelerating at the moment. I feel that the new advances will be increasingly more complex, and only the most high-informed and disciplined individuals will be able to capitalize on the technologies available to them to extend their lifespan. This will benefit a few people, but not enough to lift the broader average by much.

However, where I do agree with Kurzweil and other Futurists is the concept of a Technological Singularity and Post-Human existence. The advances in biotechnology and nanotechnology will become so advanced that humans will be able to reverse-engineer their brains re-engineer their entire bodies down to the molecular level. In fact, you could effectively transfer your 'software' (your mind) into upgraded hardware. This is not as crazy as it sounds, as even today, many devices are used within or near the body in order to prolong or augment human life, and many of these are fully part of The Impact of Computing; so both their sophistication and number could rise rapidly.

This potentially will afford immortality to the human mind for those fortunate enough to be around in 2050 or so. Of course, as the years progress, we will have a better idea of how realistic this possibility actually is.

So that is my conclusion. Average human life expectancy will make moderate but unspectacular gains for the next 50 years, with only those who maintain healthy lifestyles and are deeply aware of the technologies available to them living past the age of 100. This will be true until the Technological Singularity, where humans *may* be able to separate their minds from their bodies, and reside in different, artificially engineered bodies. This is a vast subject which I will describe in more detail in future posts. For some reading, go here.

There is a lot of speculation about whether new medical science will allow not just newborn babies to live until 100, but even people who are up to 40 years old today. But how much of it is realistic?

At first glance, human life expectancy appears to have risen greatly from ancient times :

Neolithic Era : 22

Roman Era : 28

Medieval Europe : 33

England, 1800 : 38

USA, 1900 : 48

USA, 2005 : 78

But upon further examination, the low life expectancies in earlier times (and poorer countries today) are weighed down by a high infant mortality rate. If we take a comparison only of people who have reached adulthood, life expectancy may have risen from 45 to 80 in the last 2000 years. This does not appear to be as impressive of a gain rate.

But, if you index life expectancy against Per Capita GDP, then the slow progress appears differently. Life expectancy began to make rapid progress as wealth rose and funded more research and better healthcare, and since Economic Growth is Accelerating, an argument can be made that if lifespans jumped from 50 to 80 in the 20th century, they might jump to 100 by the 2020s.

But that still seems to be too much to expect.

We hear that if cancer and cardiovascular disease were cured, average lifespans in America would rise into the 90s. We acknowledge that medical knowledge is doubling every 8 years or so. We see in the news that a gene that switches off aging has been found in mice. We even know that the market demand for such biotechnology would be so great - most people would gladly pay half of their net worth to get 20 more healthy, active years of life - that it will attract the best and brightest minds.